Effects of Combined Vitamin K2 and Vitamin D3 Supplementation on Na[18F]F PET/MRI in Patients with Carotid Artery Disease: The INTRICATE Rationale and Trial Design

INTRICATE is a prospective double-blind placebo-controlled feasibility study, assessing the influence of combined vitamin K2 and vitamin D3 supplementation on micro-calcification in carotid artery disease as imaged by hybrid Sodium [¹⁸F]Fluoride (Na[¹⁸F]F) positron emission tomography (PET)/ magnetic resonance imaging (MRI). Arterial calcification is an actively regulated process and results from the imbalance between calcification promoting and inhibiting factors. Considering the recent advancements in medical imaging, ultrasound (US), PET/MRI, and computed tomography (CT) can be used for the selection and stratification of patients with atherosclerosis. Fifty-two subjects with asymptomatic carotid artery disease on at least one side of the neck will be included in the study. At baseline, an Na[¹⁸F]F PET/MRI and CT examination will be performed. Afterwards, subjects will be randomized (1:1) to a vitamin K (400 µg MK-7/day) and vitamin D3 (80 µg/day) or to placebo. At the 3-month follow-up, subjects will undergo a second Na[¹⁸F]F PET/MRI and CT scan. The primary endpoint is the change in Na[¹⁸F]F PET/MRI (baseline vs. after 3 months) in the treatment group as compared to the placebo arm. Secondary endpoints are changes in plaque composition and in blood-biomarkers. The INTRICATE trial bears the potential to open novel avenues for future large scale randomized controlled trials to intervene in the plaque development and micro-calcification progression.     

钼靶X线检查在以钙化为唯一征象的乳腺癌诊断中的价值

目的：探讨钼靶X线检查在以簇状微小钙化为唯一征象的乳腺癌诊断中的意义。方法：34例乳腺病变患者先行钙化灶钼靶立体定位,细针穿刺注射美蓝染色,手术切除染色区域,切除标本取材,作冰冻切片及蜡片的病理诊断,比较良、恶性病变钙化的范围、单位面积（cm2）内钙化的数量以及钙化的形态、大小、分布,短期随访钙化数量的变化。结果：34例患者中乳腺癌18例,其中导管原位癌6例,早期浸润性癌4例,局部浸润性癌8例;良性乳腺病变16例。单位面积内钙化的数量：乳腺癌中83.33%〉20颗,良性病变中68.75%≤20颗;钙化类型：66.67%恶性病变为混合型,68.75%良性病变为细沙型;44.44%乳腺癌钙化的同时伴有导管分布,良性病变的钙化不伴导管分布;8例进行随访,4例钙化数量增多者均为乳腺癌,2例钙化数量减少者均为良性病变,2例钙化数量不变者,乳腺癌、良性病变各1例。结论：混合型簇状钙化、簇状钙化同时伴有导管分布、单位面积内钙化的数量大于20颗、短期内钙化数量增多,是乳腺癌的特征性钙化征象。     

67例甲状腺肿块的超声诊断

目的:探讨超声对甲状腺肿块诊断的价值。方法:回顾性分析67例甲状腺肿块超声表现,包括肿块钙化类型、回声水平、内部成分。结果:甲状腺肿块超声征象表现为有微小钙化、极低回声、均匀低回声且无囊变,诊断为恶性肿块的准确率达81%以上,含有小的或大的囊变的肿块诊断为良性肿块,准确率达90%以上。结论:甲状腺良恶肿块的超声表现有一定的差异,综合运用各超声征象对其诊断及鉴别诊断有较大的临床应用价值。     

高频彩色多普勒超声检查早期诊断甲状腺微小乳头状癌的临床价值

目的 探讨高频彩色多普勒超声检查诊断甲状腺微小乳头状癌的临床价值.方法 回顾性分析经手术和病理证实的99例甲状腺微小乳头状癌的二维声像图及高频彩色多普勒血流分布特点.结果 甲状腺微小乳头状癌声像图表现为边缘不规则,边界不清,低回声,部分结节内微钙化,侵犯甲状腺被膜,彩色多普勒显示结节内血流信号丰富,频谱呈高速高阻型,颈部淋巴结转移.结论 二维超声声像图结合彩色多普勒血流成像及颈部淋巴结检测,能明显提高甲状腺微小乳头状癌的检出率.     

高频超声对乳腺肿块微钙化的检测及临床意义

目的 探讨高频超声对乳腺肿块微钙化的检测及其临床意义.方法 选取96例乳腺肿块伴微小钙化患者,术后病理检查确诊为良性肿瘤50例（良性组）,恶性肿瘤46例（恶性组）,通过高频超声探查显示钙化灶的分布与特点并比较两组的区别,同时探讨患者年龄与微钙化的关系.结果 两组均以微钙化多见,良性组34例（68.00％）,恶性组44例（95.65％）,恶性组的微钙化所占比例明显高于良性组,经比较差异有统计学意义（x2=12.0252,P=0.001）.其中良性组的微钙化灶多呈散点状分布,而恶性组的微钙化灶多呈簇状分布,组间比较差异有统计学意义（x2值分别为12.5458,37.4088,P＜0.001）.良性组的粗钙化所占比例与恶性组相似（x2=2.3490,P=0.1254）,弧形钙化所占比例明显高于恶性组（x2=8.029,P=0.005）.良性组的微钙化者以＞45岁居多,而恶性组的微钙化以≤45岁者为主,两组比较差异有统计学意义（x2=6.0711,P=0.0137）.结论 高频超声能够有效显示乳腺肿块内钙化的类型,有助于乳腺良恶性肿块的鉴别诊断.     

超声萤火虫成像技术在检测乳腺癌微钙化中的应用

目的探讨超声＂萤火虫＂成像技术检测乳腺癌中微小钙化灶的临床应用价值。方法选择经手术病理证实的192例乳腺肿瘤患者,行常规超声与超声＂萤火虫＂成像检查。分别计算微钙化灶的单簇直径（〈20 mm和≥20 mm）,数目（0-4、5-10和〉10）。最后,按3个年龄组（20-35岁,36-50岁,51-68岁）将乳腺癌患者分组,并进行统计学分析。结果 192例中,常规超声检出钙化41例,良性10例,恶性31例;超声＂萤火虫＂成像检出钙化73例,良性21例,恶性52例。常规超声未检出而超声＂萤火虫＂成像显示的钙化41例,其中良性10例,恶性31例。超声＂萤火虫＂成像检出微钙化灶及恶性病灶优于常规超声组（P〈0.05）,其中50岁以上年龄组优势明显（P〈0.05）。结论与常规超声相比,超声＂萤火虫＂成像可显著提高乳腺癌及微小钙化灶的检出率,尤其是在50岁以上患者中,提高超声对乳腺癌诊断的准确率。